Dietary and physical activity interventions are considered the cornerstone in obesity management, however their efficacy at community settings has not been established. To delineate the impact (changes in diet quality and physical activity) and outcome evaluation (changes in BMI and cardiovascular risk markers) among families at risk for type 2 diabetes mellitus (based on the Finnish Diabetes Risk score) of the Feel4Diabetes, a two-years community intervention on healthy and active living, implemented in 6 European countries. Participants were adults at risk of developing diabetes. The intervention included counseling group sessions during year 1 and text messages during year 2. Diet was assessed through food frequency questionnaires and physical activity by daily steps. The intervention led to a significant increase in diet quality and physical activity, compared to controls. Although no change in BMI was observed, the intervention, compared to control, had beneficial impact on waist circumference (-1.1 ± 0.4 vs. +1.1 ± 0.4 cm), blood glucose (+ 1.1 ± 0.35 vs. +2.6 ± 0.5 mg/dL), total cholesterol (-6.7 ± 1.7 vs. -1.0 ± 1.4 mg/dL), LDL-cholesterol (-4.8 ± 1.4 vs. +0.4 ± 1.1 mg/dL) and diastolic blood pressure (-0.8 ± 0.4 vs. +0.7 ± 0.4 mmHg). Both an increase in diet quality or physical activity were associated with a favorable effect on waist circumference, but only an increase in diet quality was furtherly associated with favorable outcome on total and LDL-cholesterol. A community-based intervention may increase diet quality and physical activity levels and may improve cardiovascular markers, without weight loss, in individuals at risk. An increase in diet quality was a prerequisite for improving lipid profile. The Feel4Diabetes may serve as a paradigm of cost-effective and scalable interventions for enhancing public health. Diet and physical activity have been considered as the basic components of any intervention for the prevention or treatment of obesity and cardiovascular diseases. However, their efficacy at the community level has not been firmly tested. In addition, there is scarce of information regarding adherence to diet and physical activity in such interventions. The Feel4Diabetes study was a community intervention focusing on active living and improvements of diet in individuals at high risk for developing type II diabetes in six European countries. Here we show that an improvement in cardiovascular risk markers is achievable in such interventions, without a concomitant weight loss. Improvements in diet quality and increases in physical activity were observed at similar proportions in the intervention group. Both an improvement in diet and physical activity were associated with a favorable outcome on waist circumference. An improvement in diet, but not in physical activity, was furtherly associated with an improvement in lipidemic profile. Interventions on diet and physical activity may improve cardiovascular risk markers at the community settings, without a concomitant weight loss. A diet component in such interventions may be necessary for improving lipidemic profile. The Feel4Diabetes may serve as a paradigm on how individuals at risk may be reached at the community settings and on what components such interventions should include.
Low-carbohydrate dietary (LCD) patterns have been linked with cardiovascular disease (CVD). However, it remains uncertain whether proteomic signatures reflect adherence to these dietary patterns and whether these signatures are associated with CVD risk. This study included 19,655 participants with complete dietary and proteomic data from the UK Biobank. The LCD score was calculated based on the percentage of energy from carbohydrates, fat, and protein, as estimated by 24-hour dietary recalls. Multivariable linear regression and elastic net regression with repeated nested cross-validation were used to characterize LCD-related plasma proteomic profiles and derive proteomic signatures. Multivariable Cox models estimated the associations of LCD scores and their proteomic signatures with CVD risk. Mediation analyses further assessed the potential mediating effects of plasma proteins. Over a median follow-up of 11.6 years, 1,506 incident CVD events were documented. elastic net regression with repeated nested cross-validation identified proteomic signatures comprising 405, 173, and 367 proteins for the total, vegetable-based, and animal-based LCDs, respectively. In multivariable Cox regression analyses, the total LCD proteomic signature was not significantly associated with CVD risk (hazard ratio [HR] for the highest vs. lowest quartile: 0.98, 95
To systematically identify, appraise and map the available evidence on dietary and nutrition-related exposures in microscopic colitis (MC), addressing the risk of incident MC and symptom control, and to summarise current guideline statements. We searched PubMed, Embase and the Cochrane Library from inception to 16th June 2025 following a pre-registered PROSPERO protocol (CRD420251069881). Eligible studies were randomized controlled trials, non-randomized interventional studies, cohort, case–control and cross-sectional studies, case series and case reports assessing dietary or nutrition-related exposures or interventions in relation to incident MC or to MC symptoms. Guidelines and position papers were retrieved from an ancillary search and are reported descriptively. Twelve studies were included (7 addressing incident MC risk, 5 addressing dietary management of diagnosed MC). Macronutrients, fibre, zinc and gluten were not associated with incident MC. Alcohol pointed towards higher risk: dose-dependent in one large cohort (≥ 15 g/day vs. non-users: aHR 2.31, 1.54–3.46), imprecise in a second (HR 1.89, 0.82–4.33), null in a case–control study. Dietary calcium was inversely associated with MC in one case–control study (adjusted OR 0.22, 0.07–0.76); coffee, wine, low-energy beverages and dietary inflammatory potential came only from conference abstracts. Symptom-control evidence comprised one non-randomized controlled study (tryptophan reduction with budesonide), two case series (elemental diet; withdrawal of a turmeric-containing supplement) and two case reports (gluten-free diet; starch- and sucrose-reduced diet). Certainty was very low for every exposure and outcome domain, with risk of bias from low-moderate (cohorts) to high. Evidence on diet and nutrition-related exposures in MC remains scarce, heterogeneous and almost entirely observational, precluding firm dietary recommendations. Pending MC-specific trials, dietary advice should be framed as cautious, individualized clinical management aimed at preserving nutritional adequacy and avoiding unsupervised elimination diets.
Food literacy provides a multidimensional framework for understanding dietary behaviors, and accurate measurement can helpfully inform development and evaluation of food education programs that promote healthy dietary habits. Existing tools for assessing children’s food literacy, however, have primarily been developed from adult-centered conceptual models. The objective of this study was to develop a novel tool—the Food Literacy BITE scale—based on four child-centered food literacy dimensions and evaluate its measurement properties among elementary schoolchildren in the U.S. Items were developed for four dimensions: food system and nutrition knowledge, confidence in everyday food skills, valuing shared food experiences, and purposeful engagement with food. An expert panel (n = 10) provided two rounds of review to establish item and scale-level content validity. Elementary students (n = 43) in 4th and 5th grade ( 9–12 years) participated in group cognitive interviews to assess comprehensibility in the target population. We tested the scale with a socioeconomically and culturally diverse sample of 690 elementary schoolchildren across 10 different schools, primarily in urban settings. Structural validity of the proposed model with four first-order factors and a second-order food literacy factor was tested with confirmatory factor analysis (CFA), and internal consistency was evaluated using composite reliability values. Expert review yielded a 20-item scale with acceptable content validity, and cognitive interview findings informed item revisions to improve comprehensibility. CFA supported the proposed model structure with acceptable values across model fit indices (CFI = 0.96, TLI = 0.95, RMSEA = 0.046, SRMR = 0.051), and all item loadings ≥ 0.45. Two items were removed for cross-loading, resulting in an 18-item validated scale. Internal consistency was acceptable for food literacy overall (0.74) and adequate for each of the individual dimensions (range: 0.62–0.71). The Food Literacy BITE scale offers a novel tool for measuring children’s food literacy, based on child-centered dimensions and validated among a diverse sample. The tool further provides new measurement indicators for under-studied dimensions of food literacy in children. This scale can be used to aid in guiding and evaluating programs and interventions to support children in developing healthy dietary behaviors and habits. Not applicable.
Creatine is obtained through endogenous synthesis and meat-based dietary sources. This study investigated whether a meat-free diet alters maternal creatine homeostasis during pregnancy and whether creatine-related metabolites are associated with newborn growth. This nested study included 24 non-meat eaters and 39 meat eaters from the Australian Creatine and Pregnancy Outcomes cohort. Dietary intake was assessed throughout pregnancy. Creatine, guanidinoacetate (GAA), creatinine and amino acids involved in creatine synthesis were measured in maternal plasma and urine, placental tissue and cord bloods. Mixed-effects models examined longitudinal metabolite concentrations and exploratory associations with newborn growth. Non-meat eaters had 30
